Short-Term Fixes, Long-Term Gaps: Addressing Rural Health Workforce Challenges in Queensland.

IF 2.4 4区 医学 Q2 NURSING
Thu Nguyen, Lana M Elliott, Karen Johnston, Stephanie M Topp
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Abstract

Purpose: To assess the scope and distribution of rural health workforce policies at both national and state (Queensland) levels through a systematic analysis of their status and characteristics.

Methods: A mapping review was adopted, with rural health workforce policy documents identified and extracted from websites of the national Department of Health and Aged Care, Queensland Health, and Queensland's Rural Workforce Agency. Documents were coded for demographic data, policy type, health profession, and overarching strategic focus on health workforce supply, distribution, and performance.

Findings: From the total of 12 921 rural health workforce policy documents identified in national and state repositories, 118 documents (67 national and 51 Queensland state) were included for synthesis. Analysis showed that the national rural health workforce policy is dominated by short-term mixed policy instruments-grants, programs, and sub-programs. After 2018, national policy showed a more balanced coverage of supply, distribution, and performance, compared with the stronger supply emphasis evident among policies issued before 2018. Queensland-specific policy places greater emphasis on retention, primarily through incentives embedded in employment policies, including financial allowances, leave, development opportunities, and workload management provision. However, these policies give limited attention to broader drivers of retention that are well established in the literature, including social, cultural, and work environment factors. Policy attention to performance is relatively narrow, focusing more on individual or professional outcomes than on system-level workforce outcomes.

Conclusion: Findings highlight the complexity and underlying fragmentation of Australia's rural health workforce policy. The layering of multiple nationally driven programs alongside state-level employment policy makes it difficult to assess the individual scope, overall coherence, interaction, and impact of health workforce policy in rural and remote regions.

短期修复,长期差距:解决昆士兰州农村卫生人力的挑战。
目的:通过系统分析农村卫生人力政策的现状和特点,评估国家和州(昆士兰州)各级农村卫生人力政策的范围和分布。方法:采用地图审查,从国家卫生和老年护理部、昆士兰州卫生部和昆士兰州农村劳动力局的网站上识别和提取农村卫生人力政策文件。根据人口统计数据、政策类型、卫生专业以及卫生人力供应、分布和绩效的总体战略重点对文件进行编码。结果:从国家和州知识库中确定的总共12921份农村卫生人力政策文件中,118份文件(67份国家文件和51份昆士兰州文件)被纳入综合。分析表明,国家农村卫生人力政策以短期混合政策工具为主——赠款、项目和子项目。2018年之后,国家政策呈现出供给、分配和绩效覆盖更加均衡的格局,而2018年之前出台的政策则更加强调供给。昆士兰州的具体政策更加强调留用,主要是通过在就业政策中嵌入激励措施,包括财政津贴、休假、发展机会和工作量管理规定。然而,这些政策对文献中确立的更广泛的挽留因素关注有限,包括社会、文化和工作环境因素。政策对绩效的关注相对狭窄,更多地关注个人或专业成果,而不是系统层面的劳动力成果。结论:研究结果突出了澳大利亚农村卫生人力政策的复杂性和潜在的碎片化。多个国家驱动的项目与州一级的就业政策分层,使得很难评估农村和偏远地区卫生人力政策的个别范围、整体一致性、相互作用和影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Australian Journal of Rural Health
Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.30
自引率
16.70%
发文量
122
审稿时长
12 months
期刊介绍: The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.
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